The Grand Rapids Clinical Oncology Program (GRCOP) has achieved a national reputation for excellence in community cancer care through its 34-year participation in programs of the National Cancer Institute. The GRCOP comprises a consortium of seven health care systems/hospitals in Western and Northern Lower Michigan and seeks to continue to meet the community's need for innovative and relevant studies of promising therapeutic modalities and cancer controls research. The ongoing mission of the Grand Rapids Clinical Oncology Program is to assure that every person in the region served is provided an opportunity for participation in national cancer prevention and treatment clinical trials. Additionally, it is a major educational resource for professional and laypersons alike regarding cancer and the NCI clinical trials program. This grant application encompasses and articulates an ever-expanding vision for the GRCOP. Key strategies to increase patient access and accrual to research protocols include: (1) expansion of on-site screening and patient identification for enrollment in research protocols; (2) strengthening referral systems for symptom management trials to include physician specialists and allied health professionals; (3) maintaining a protocol menu that is comprehensive yet efficient to administer; (4) expansion of the Radiation Therapy Oncology Group (RTOG) as a research base for all component sites; (5) implementing a targeted clinical trials program for adolescents/young adults with increased protocol availability for this population. Strategic initiatives to increase access to and participation in cancer clinical trials by underserved and minority populations include alignment with community organizations; a key element in this regard will be the work of the GRCOP Patient Advisory Board. An expanding focus on the growing Hispanic/Latino population is planned. Of importance during this upcoming grant cycle will be the GRCOP's ongoing development of the GRCOP website in order to improve the efficiency and cost-effectiveness of clinical trial administration and regulatory compliance.